Temporomandibular custom hemi-joint replacement prosthesis: prospective clinical and kinematic study

Purpose: Evaluate the clinical and functional outcome of a custom temporomandibular hemi-joint fossa/eminence implant prosthesis.

Materials and methods: Prospective IRB protocol study of 36 patients (40 custom TMJ implant prosthesis) with CT documented advanced osteoarthritis who satisfy stated inclusion criteria. Visual analog scale (VAS) clinical data was collected presurgically and 3, 6, and 12 months postsurgically to evaluate pain experience, pain intensity, chewing ability, jaw opening, joint noise, and overall satisfaction with the surgical outcome. Pre- and postsurgical kinematic data was collected of maximum incisal opening, operated and unoperated condyle translation, and mandibular body rotation, by utilizing and combining mandibular kinematic data and patient-specific computed tomography (CT) data.

Results: Clinical data documented:

  • (1)

    Pain experience and pain intensity was reduced over 605 compared to the preoperative value at the three post-op recovery time observation.

  • (2)

    Chewing ability, jaw opening, and joint noise all exhibited 50% or more improvement over the 12 month observation.

  • (3)

    Kinematic data reveals preservation of condylar motion, mandibular body rotation and mandibular incisor motion.

  • (4)

    Overall surgical outcome satisfaction mean was over 8 (out of 10) for all three postoperative observation periods.

Conclusion: Temporomandibular hemiarthroplasty with custom metal fossa/eminence prosthesis provides satisfactory clinical and functional outcome. A favorable surgical revision/reoperation rate was documented when the surgical technique and custom metal fossa was utilized for advanced osteoarthritis in patients with focal joint pain secondary to CT documented joint pathology.

Conflict of interest: None declared.

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Feb 5, 2018 | Posted by in Oral and Maxillofacial Surgery | Comments Off on Temporomandibular custom hemi-joint replacement prosthesis: prospective clinical and kinematic study
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